Shrinkage of specimens after CO2 laser cordectomy: an objective intraoperative evaluation

Mariani, Cinzia; Carta, Filippo; Tatti, Melania; Marrosu, Valeria; Gerosa, Clara; Puxeddu, Roberto

doi:10.1007/s00405-021-06625-8

Cited by 8 publications

(6 citation statements)

References 43 publications

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“…The median values of thermal spread with the ultrapulsed system were lower: 13 µm instead of 17 µm obtained with the superpulsed laser. These results are comparable and even better if compared to other similar data reported in the literature [21].…”

Section: Laser Performancesupporting

confidence: 90%

Scanning Super/Ultrapulsed CO2 Laser Efficacy in Laryngeal Malignant Lesions

Dallari¹,

Giannoni

Filosa³

2022

Medicina

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Introduction: The authors review their experience in transoral laryngeal microsurgery (TLM) that they performed with two different CO2 laser devices from the same company, which were both equipped with a micromanipulator and digital scanner. Material and Methods: A total of 91 glottic and glotto-supraglottic cancers were treated during the years 2009–2016 and then analyzed in relation to the laser performances and the long-term oncologic results. Results: Laser devices proved to be very efficient and the UP mode was confirmed to be the best in terms of cutting precision and lowest thermal damage. Conclusions: CO2 laser TLM is the preferred option for the majority of small–medium size glottic and supraglottic cancers and may also be used for bigger tumors, especially in older patients.

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Section: Laser Performancesupporting

confidence: 90%

Scanning Super/Ultrapulsed CO2 Laser Efficacy in Laryngeal Malignant Lesions

Dallari¹,

Giannoni

Filosa³

2022

Medicina

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“…[24][25][26] In TOLMS, the difficulty relies upon determining what can be considered a negative margin, because monoblock resection is not usually feasible in advanced tumors and shrinkage of the mucosal specimen can exceed 3 mm. 27 In our institution, the surgical limits include the internal perichondrium of the thyroid cartilage, with partial resection or laser vaporization of the cartilage when focal infiltration is suspected by the surgeon. Frozen sections are usually performed from the margins of the tumor bed.…”

Section: Discussionmentioning

confidence: 99%

Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments

et al. 2021

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Background: To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Methods: Two hundred and two consecutive pT3-T4a larynx carcinomas. Pre-epiglottic space involvement, anterior and posterior paraglottic space (PGS) involvement, vocal cord, and arytenoid mobility were determined. Local control with laser (LC), overall survival (OS), disease-specific survival (DSS), and laryngectomy-free survival (LFS) were evaluated. Results: The lowest LC was found in tumors with fixed arytenoid. In the multivariate analysis, positive margins (hazard ratio [HR] = 0.289 [0.085-0.979]) and anterior (HR = 0.278 [0.128-0.605]) and posterior (HR = 0.269 [0.115-0.630]) PGS invasion were independent factors of a reduced LC. Anterior (HR = 3.613 [1 .537-8.495]) and posterior ) PGS involvement were

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“…When compared to open surgery, assessment of tumour margins during and after CO 2 TOLMS is hampered by thermal damage and shrinkage of the small specimens, potentially reaching 29% in its anteroposterior length 6 . For this reason, discrimination between R0 and R1 margins may be a complex task for the pathologist, with some arguing that single close/positive superficial margins can play a secondary role in defining subsequent oncologic outcomes 6 , 7 . Clearly, the influence of multiple positive superficial and deep margins may be greater, macroscopically reducing the rate of local control of disease.…”

Section: Introductionmentioning

confidence: 99%

“…Carbon dioxide transoral laser microsurgery (CO 2 TOLMS) as defined by the European Laryngological Society (ELS) 1 is a well-established treatment option for early (T1-T2) and selected T3 glottic tumours [2][3][4][5] . When compared to open surgery, assessment of tumour margins during and after CO 2 TOLMS is hampered by thermal damage and shrinkage of the small specimens, potentially reaching 29% in its anteroposterior length 6 . For this reason, discrimination between R0 and R1 margins may be a complex task for the pathologist, with some arguing that single close/positive superficial margins can play a secondary role in defining subsequent oncologic outcomes 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging to assess cartilage invasion in recurrent laryngeal carcinoma after transoral laser microsurgery

Ravanelli

Lancini

Maroldi

et al. 2022

Acta Otorhinolaryngol Ital

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SUMMARY Objective To evaluate the diagnostic performance of magnetic resonance (MR) with surface coils in assessing cartilage invasion in recurrent laryngeal carcinoma after carbon dioxide transoral laser microsurgery (CO 2 TOLMS). Methods Two expert head and neck radiologists assessed cartilage invasion (infiltrated or non-infiltrated) in submucosal recurrences of laryngeal carcinoma after CO 2 TOLMS: results were compared with histopathological report after salvage laryngectomy. Results Thirty patients met the inclusion criteria and 90 cartilages were assessed. Overall sensitivity, specificity, and positive and negative predictive values for cartilage infiltration were 76, 93, 72 and 94%, respectively; for thyroid cartilage, the values were 82, 79, 69 and 88% respectively; for cricoid cartilage, all values were 100%; and for arytenoids, the values were 33, 96, 56 and 93% respectively. Conclusions MR with surface coils was able to detect most thyroid and cricoid infiltration in the complex setting of post-CO 2 TOLMS laryngeal carcinoma recurrence. In particular, the optimal performance in assessing cricoid invasion can be valuable in choosing the most appropriate treatment among total laryngectomy, open partial horizontal laryngectomies and non-surgical strategies.

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Shrinkage of specimens after CO2 laser cordectomy: an objective intraoperative evaluation

Cited by 8 publications

References 43 publications

Scanning Super/Ultrapulsed CO2 Laser Efficacy in Laryngeal Malignant Lesions

Scanning Super/Ultrapulsed CO2 Laser Efficacy in Laryngeal Malignant Lesions

Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments

Magnetic resonance imaging to assess cartilage invasion in recurrent laryngeal carcinoma after transoral laser microsurgery

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